The popularity of pickleball continues to increase, and there’s no sign of stopping. But while it’s relatively safe for all ages, some players may encounter injuries, especially in the joints. One of the most common complaints is the knee injury.
Regarding speed and space, pickleball is more forgiving than tennis. However, some movements can lead to knee pain. In today’s post, we’ll focus on how to manage and overcome knee injuries and some exercises to help prevent them.
Understanding the Knee and its Function
Before we continue, it will be helpful if we first understand our knees and their function.
Our knee is a hinge joint with three bones - the femur (thigh bone), tibia (shin bone or lower leg bone), and patella (kneecap). The femur and tibia form the main knee joint, while the patella is joined to the femur to create a third joint called the patellofemoral joint.
Around the knee is a joint capsule with ligaments inside and outside and crossing within it. These ligaments make our knees stable and robust. Meanwhile, a thickened cartilage pad called the meniscus is located between the two joints formed by the femur and tibia. It serves as a smooth surface on which our knee joint moves while we are moving.
Being the biggest joint in our body, our knee allows our legs to move so we can walk, run, jump, and perform other related activities. Typically, it can rotate to a maximum of 135 degrees and extend to 0 degrees. Our knees also support our body and help us keep our balance while moving. In short, we cannot function well with an injured knee.
Types of Pickleball Knee Injuries
Several types of knee injuries exist, and three are common in pickleball. Although old age and underlying health conditions are factors, young and healthy people may also encounter them. Therefore, you must understand each type and how they happen.
Knee Sprains
Knee sprains are common to players with osteoarthritis, the most common type of arthritis, usually affecting older people. Also known as degenerative joint disease, knee osteoarthritis is when the articular cartilage of your knee joint breaks down. This illness has no cure, but some treatments can slow progress. If you have this condition, it can be aggravated once you twist your knees while trying to return a shot.
Meniscus Tear
Meniscus tears usually occur when you force your knees to twist or rotate, especially when you put your total weight on them. Although pickleball can be one of the causes, any person can have a torn meniscus at any age. For older people, getting up from a chair with an awkward twist can cause a tear to the meniscus. For pickleball players, making a sudden stop or change of direction can lead to having a torn meniscus.
Patellar Tendinitis
Also known as a jumper's knee, patellar tendonitis is most common in sports that involve jumping, such as basketball and volleyball. However, this knee injury can also occur in people who frequently jump on hard surfaces. In pickleball, players who jump repetitively or squat without moving their legs much can have patellar tendinitis, the early stage of tendonitis. If not treated, it can eventually cause your tendon to tear.
Common Causes of Knee Injury in Pickleball
Pickleball offers a lower risk of injuries compared to tennis. But again, some positions and body movements can be unbearable to your knees. This section will tackle the most common causes of knee injuries.
Improper Form
Like other injuries, a knee injury in pickleball can be due to improper playing form and techniques. For instance, being in a ready position at the baseline requires you to bend your knees to move in any direction quickly. But if you bend them too much and long, your knees will eventually hurt while lifting your weight.
Sudden Movements
The most exciting battle in pickleball typically happens when all players are at the non-volley zone line. Yet, the 14-foot distance between you and your opponent forces you to do sudden twists and lateral movements to return the ball. Unknowingly, you are gradually developing a knee injury as you try to endure the pain.
Repetitive Strains
A strain (or pulled muscles) is an injury to muscles or tendons, while a sprain affects the ligaments, which could lead to an unstable joint. In pickleball, a knee strain is usually caused by pivoting too quickly or overextending your knees. Repetitive knee strains can lead to overworked and damaged muscles, and severe strains may require surgery.
Degenerated Knees
As mentioned earlier, knee sprains are usually triggered by osteoarthritis. Our knees weaken as we age, leading to wear and tear. Hence, veteran pickleball players are likely to have degenerated knees. Yet, some cases are hereditary or due to being overweight. Osteoarthritis is also thought to be more common in women than in men.
6 Knee Strengthening Exercises for Pickleball Players
You can find many knee-strengthening exercises on YouTube. However, because we are focused on pickleball players, I found one that I think is the most applicable. Below is the step-by-step guide on how to do them:
#1 Calf Stretch
- Get a stretch strap, a belt, or a strong rope.
- Sit comfortably on your couch, and put the strap around the ball of your foot.
- Hold the strap and pull it slightly to lengthen your leg muscles.
- In doing so, you should feel a slight pressure under your knee.
- Hold the strap for about 30 seconds, and then release it.
- Repeat this exercise three times.
#2 Hamstring Stretch
- While still holding the strap, lie down comfortably on the couch.
- You can also use a pillow for your head or straighten your other leg.
- Pull your leg slowly using the strap, but keep your knee straight.
- You can feel pressure on your hamstrings (the muscles at the back of your thigh).
- Hold the strap for about 30 seconds, then put down your leg.
- Repeat this exercise three times.
#3 Quad Stretch
- This time, put the strap around your ankle.
- Roll over, bend your leg, and gently pull the strap.
- You will feel some pressure on your front thigh and knee.
- Hold the strap for about 30 seconds and slowly put your leg down.
- If after 20 seconds you can still pull it further, do it for another 10 seconds.
- Repeat this exercise three times.
The above exercises require some movements and may make you feel uncomfortable. Alternatively, you can activate your muscles by doing some isometric exercises. Here, you may need a rolled-up towel, a small foam roll, a pillow, or a small ball.
#4 Quad Set
- Sit comfortably and put the foam roll under your knee.
- Push your knee down to the roll to activate your quad muscles.
- Hold that position for 3-5 seconds, and then relax.
- You can do it for a bit longer as long as you don’t hurt yourself.
#5 Hamstring Set
- In the same sitting position, this is similar to the hamstring stretch.
- But instead of lifting your leg, simply dig your heel into the couch.
- You will feel a little tension in your hamstring, which is the primary purpose.
- Hold that position for 3-5 seconds, and then relax.
- If you’re pushing about 20-30%, you can increase it to 40-50% the next time.
#6 Isometric Hip Abduction
- Place the loop of the stretch strap just above your knees.
- Push your knees outward into the strap.
- Alternatively, use your hands to contract your knees.
- You will then feel some pressure on your knees and your hips.
- Like in the previous exercises, hold that position for 3-5 seconds, then relax.
- For the inward push, get a pillow or a ball small enough to fit between your knees.
- Squeeze the pillow or the ball with your knees for about 20-30%.
To help you visualize these exercises, watch Doctor Jo’s video tutorial below.
Disclaimer: The exercises above are not intended as medical advice. Always consult your doctor or physical therapist before trying any of them, especially if you have had past knee injuries.
Knee Injuries Prevention Tips
Aside from strengthening exercises, there are other ways to avoid knee injuries in pickleball. Some can be done before the game, while the rest should be observed while playing.
Maintain a Healthy Weight
Being overweight could be problematic when moving in different directions on the court. It not only prevents you from moving faster but also adds pressure to your knees, increasing your risk of knee osteoarthritis.
Improve Your Posture
Poor posture can trigger knee pain, which could lead to injuries. Don’t bend your knees too low, especially while in the ready position or engaging in a dinking battle. When changing directions, turn on the balls of your feet instead of twisting your knees.
Wear Appropriate Footwear
Never wear running shoes in pickleball. They are not designed for lateral movements and cause discomfort to your feet. Prolonged use can also lead to various knee injuries. Although tennis shoes are fine, pickleball shoes are a better option.
Wear Knee Sleeves or Braces
Knee sleeves are usually made of elastic fabric and offer light-to-moderate support. On the other hand, knee braces are typically bulky metal and plastic materials. They are designed to rehabilitate and heal knee injuries or after surgery.
Can I Play Pickleball If I Have Knee Arthritis?
Yes, you can play pickleball even with knee arthritis (osteoarthritis). However, you should follow the tips above, play with extra caution, and limit your movements. Otherwise, you can quickly get knee sprains. Most importantly, consult with your doctor or physical therapist for proper exercises.
Can I Still Play Pickleball After a Knee Replacement Surgery?
It depends on the advice of your surgeon and physical therapist. However, according to Dr. Nathan Cafferky, a board-certified orthopedic doctor, most patients can play pickleball again after knee replacement surgery. The right time to return to the court mainly depends on the patient’s condition.
Final Thoughts
Pickleball is a low-impact sport and doesn’t require players to have a high fitness level. In fact, many baby boomers and retirees are playing the sport. But still, you have to protect your knees regardless of your age. If you feel something wrong with your knees, rest and consult your doctor immediately.
